https://pubmed.ncbi.nlm.nih.gov/34953814/ liver transplant

J Pediatr. 2021 Dec 22;S0022-3476(21)01240-3.
doi: 10.1016/j.jpeds.2021.12.033.Online ahead of print.

Impaired Neurocognitive Performance in Children After Liver Transplantation

Anniken B Østensen 1, Anne-Britt Skarbø 2, Truls Sanengen 2, Pål-Dag Line 3, Runar Almaas 4

Abstract

Objectives: To assess longitudinal neurocognitive development after liver transplantation and evaluate factors associated with neurocognitive performance.

Study design: Data from neurocognitive testing of 65 children (<18 years of age) who received a liver transplant at Oslo University Hospital from 1995 to 2018, were collected from the testing program after transplantation. The parents-reported version of the Behavior Rating Inventory of Executive Function (BRIEF) was used to assess executive function.

Results: A total of 104 neurocognitive tests were conducted on 65 patients. At the first test, 4.1(1.5-5.3) years after transplantation (with a median age of 6.7(5.4-10.5) years) the mean full scale intelligence quotient (FSIQ) was 91.7±14 and verbal comprehension index was 92.0±14.5. No significant difference in FSIQ (87.4±12.9 vs. 88.5±13.2 (p=0.58)) was found between the first and last test at 5.8 (5.2-8.5) and at 10.8 (9.8-12.9) years of age in the 30 patients tested more than once. Recipients younger than one year of age (n=30) had lower FSIQ (87.1±12.6 vs. 96.6±13.8 (p=0.005)) and verbal comprehension index (87.3±13.8 vs. 95.4±13.0 (p=0.020)) than those
transplanted after the age of one year (n=35). Age at transplantation (p=0.005,
adjusted for cholestasis: p=0.038) and transfusion >80ml/kg (p=0.004, adjusted for age at transplantation: p=0.046) were associated with FSIQ.

Conclusions: Young age at transplantation and large blood transfusions during transplantation are risk factors for poor neurocognitive performance later in life. Children transplanted before one year of age have a significantly lower neurocognitive performance compared with those transplanted later in childhood. Cognitive performance did not improve over time after transplantation.